Long-term effects of a playground markings and physical structures on children's recess physical activity levels.

OBJECTIVE The aim of the study was to investigate the impact of a playground redesign intervention across time on children's recess physical activity levels using combined physical activity measures and to evaluate the potential influence of covariates on the intervention effect. METHOD Fifteen schools located in areas of high deprivation in one large city in England each received 20,000 pounds through a national 10 million pounds Sporting Playgrounds Initiative to redesign the playground environment based on a multicolored zonal design. Eleven schools served as matched socioeconomic controls. Physical activity levels during recess were quantified using heart rate telemetry and accelerometry at baseline, 6 weeks and 6 months following the playground redesign intervention. Data were collected between July 2003 and January 2005 and analyzed using multilevel modeling. RESULTS Statistically significant intervention effects were found across time for moderate-to-vigorous and vigorous physical activity assessed using both heart rate and accelerometry. CONCLUSIONS The results suggest that a playground redesign, which utilizes multicolor playground markings and physical structures, is a suitable stimulus for increasing children's school recess physical activity levels.